Medicaid won't be used to pay guardians for developmentally disabled

Tuesday

Aug 30, 2011 at 12:01 AMAug 30, 2011 at 3:16 AM

The Ohio Department of Developmental Disabilities stopped seeking Medicaid funding to pay for protective services for thousands of adults after state auditors questioned the agency's accounting for more than $1.3 million in program costs.

The Ohio Department of Developmental Disabilities stopped seeking Medicaid funding to pay for protective services for thousands of adults after state auditors questioned the agency’s accounting for more than $1.3 million in program costs.

To avoid any interruption in services for the mentally retarded and disabled, Director John Martin said he is using non-Medicaid tax dollars to cover the expense.

“These are vital services,” he said.

An audit released by the Department of Job and Family Services questions the 2009 and 2010 expenditures but does not seek repayment of the funds paid to Advocacy & Protective Services Inc.

“DODD did not provide adequate documentation to demonstrate the expenditures, used as a basis for claiming Medicaid reimbursement, were for actual and allowable services provided by APSI,” auditors wrote.

The Department of Job and Family Services oversees Medicaid, the health-care program for the poor and disabled funded through state and federal tax dollars. Department spokesman Benjamin Johnson said DODD will have an opportunity to submit a more-detailed accounting before any decision about repayment is made.

Advocacy & Protective Services (APSI) is a private, nonprofit organization based in Columbus that is under contract with the developmental-disabilities agency to serve as a court-appointed legal guardian and trustee for about 4,800 Ohioans with mental retardation or other developmental disabilities.

Auditors are concerned about Medicaid funds paid to the department after it sought reimbursement of APSI administrative expenses. Specifically, auditors noted that invoices showed only total costs paid APSI and did not include a breakdown for specific services.

Medicaid, auditors previously noted, will reimburse for administrative costs, within limits, if a detailed accounting is provided to show the expenditures were permissible. Such documentation must include a description of the services performed, hours and date worked, and a signature of an authorizing agent. In addition, 90 percent of the expenditures must go to direct services.

Martin said APSI is paid a set fee to cover administrative expenses and there are no itemized invoices.

“DODD provided documentation of payroll and operation expenses that we believe demonstrate the costs were necessary and reasonable to provide required protective services to individuals with developmental disabilities,” the developmental-disabilities agency wrote in a response included in the audit.

The department also noted that APSI guardians are paid an average of $17.19 an hour, and the cost per individual served is about $1,079 a year.

“We feel confident that DODD is getting a good value for this critical service.”